HMSSubstanceUseandPainCurriculum

CLERKSHIP CURRICULUM PRIMARY CARE and MEDICINE-AMBULATORY

Pain: Pain Assessment

• Acute Pain • Chronic Pain

Pain Management • Opioid, non-opioid pharmacologic approaches • Non-medication approaches to pain • Safe prescribing principles including safe storage and disposal

Patient agreements (for treatment with opioids and other controlled substances) Opioid prescribing regulations including PDMP

Substance Use: SBIRT:

• Screening for SUD and unhealthy alcohol use • Brief Intervention including Motivational Interviewing • Referral to specialty SUD treatment

SUD treatment including buprenorphine MEDICINE - INPATIENT

Pain: • Management of Acute Pain • Approach to medical inpatient with SUD including pain management

Substance Use: • Common medical complications of substance use • Inpatient management of withdrawal including alcohol withdrawal delirium • Harm reduction including overdose prevention and naloxone • Nutritional deficiencies associated with SUD • Approach to medical inpatient with SUD including pain management • Initiation of SUD treatment on inpatient setting • Referral to outpatient SUD treatment

SURGERY including ANESTHESIA

Pain: • Perioperative pain management • Anesthesia modalities for pain relief including regional analgesia • SUD risk factor assessment

Substance Use: • Recognizing and managing Post-op withdrawal • SUD diagnosis and referral to treatment following surgery, trauma

OBSTETRICS and GYNECOLOGY

Pain: • Pain management during labor and delivery • Perioperative pain management

• Chronic pain in Ob-Gyn setting Substance Use:

• Neonatal Abstinence Syndrome • SUD and pregnancy, breastfeeding • Developmental toxicity of substances

PEDIATRICS

Pain: • Pediatric pain management

Substance Use: • Adolescent substance use • Pediatric substance ingestion • Neonatal abstinence syndrome • Parental substance use and child protective services

PSYCHIATRY

Pain: • Psychological aspects of pain

Substance Use: • Screening for SUD • Brief interventions and motivational interviewing • Co-occurrence of SUD and psychiatric illness • Substance-induced mental disorders • Substance use disorder treatment • Suicide assessment in patient with SUD

NEUROLOGY Pain:

• Neuropathic pain • Headache including migraine

Substance Use: • Neurological complications of SUD including Wernicke-Korsakoff

RADIOLOGY

Pain: • Pain management during image-guided procedures

Substance Use: • Radiologic findings in SUD

POST-CLERKSHIP CURRICULUM

EMERGENCY MEDICINE

Pain: • Treatment of Acute Pain in the ED • SUD risk factor assessment when prescribing opioids • Safe prescribing principles including safe storage and disposal

Substance Use: • Overdose management and naloxone rescue • Assessing and Managing Substance Intoxication and Withdrawal • Approach to patients with SUD and Referral to SUD treatment from ED

BUPRENORPHINE TRAINING